Radiotherapy in Graves Ophthalmopathy at National Taiwan University Hospital

臺大醫院格雷夫司氏眼病之放射治療

許維中(Wei-Chung Hsu) ； 鍾娜娜(Na-Na Chung) ； 雷德(Louis Tak Lui) ； 曾鑠鑠(Soso Tseng) ； 陳斯榮(Szu-Jong Chen) ； 丁禮莉(Lai-Lei Ting)

《放射治療與腫瘤學》 6卷4期 (1999/12) Pp. 285-293

https://doi.org/10.6316/TRO/199906(4)285

摘要

目的：評估並討論台大醫院格雷夫司氏眼病放射治療之成果。
材料與方法：自1992年至1997年共有16位格雷夫司氏眼病之患者於台大醫院接受放射治療。其中8位男性，8位女性，年齡自14歲至63歲，平均年齡為42.9歲。多數病患以眼球突出、軟組織症狀及眼肌運動障礙為主。病患均接受單次劑量2Gy，總劑量20Gy之放射治療，治療範圍包含所有異常部位，經常由後眼球延伸至前床突。
結果：總計625% (10/16)的病患接受放射治療後有療效，其中軟組織症狀的改善為62.5% (10/16)。眼球突出的改善為83.3% (5/6)，眼肌運動障礙的改善為400% (4/10)，有600% (3/5)的病患在視力上獲得改善。
結論：以總劑量20Gy的放射治療可有效用於避免格雷夫司氏眼病活動期之加劇及減少類固醇治療延長使用所帶來之副作用。格雷夫司氏眼病放射治療的適應症包括：類固醇療法失敗或病患對使用類固醇有禁忌者。手術治療如眼球減壓，可用於放射治療後眼球突出持續進展或無效之病患。

關鍵字

格雷夫司氏眼病 ； 放射治療 ； 水晶體

並列摘要

Purpose: To evaluate and discuss the radietion therapeutic results of Graves' ophthamopathy treated at National Taiwan University Hospital (NTUH).
Materials & Methods: This retrospective study was to review the 16 patients with Graves' ophthalmopathy whom treated with radiation therapy at National Taiwan University Hospital from 1992 to 1997. There were Smen and 8 women, aged from 14 to 63 years old, with a mean age of 42.9 years old. Most of the patients presented with soft tissue signs, eye muscle impairment and proptosis. Patients received 20Gy in 2Gy per fraction to volume that included the entire area of abnormality and usually extended from the posterior globe to the anterior clinoids process.
Results: Sixty-three percent (10/16) of the patients responded successfully to radiotherapy. There was 62.5% (10/16) of the patients presenting with these signs demonstrated significant improvement. Patients with proptosis improved after treatment was 83.3% (5/6), respectively. Only 40.0% (4/10) of the patients showed improvement in the restriction of eye movement. Improvement of visual acuity was found in 60.0% (3/5) of the patients.
Conclusion: Radiotherapy with a dosage of 20Gy is effective in preventing exacerbation of active inflammatory ophthalmopathy in patients with Graves' disease and eliminates the side effects associated with protracted use of corticosteroid. It is recommended that radiotherapy can be considered to treat patients who fail after steroid administration or have a contraindication to steroid. Surgical management such as orbit decompression may reserved for patients who have progressing or disabling proptosis after radiation therapy.

並列關鍵字

Graves' ophthalmopathy ； Radiotherapy ； Lens